RN Utilization Management Supervisor - Remote

Centene Corp.; California (MO); On-site; USD 75,300 - 135,400; Full time

Benefits offered by this job

Health insurance

401K

Tuition reimbursement

Paid time off

Flexible work schedule

Job summary

Centene Corp. is seeking a Supervisor, Utilization Management (RN) to lead and supervise our Clinical Review team. This role focuses on ensuring appropriate care for our members and promotes adherence to compliance standards through effective team management and continuous improvement practices.

Candidates should possess a nursing degree and a valid California RN license, along with 4+ years of experience in utilization management or related fields. The position offers competitive pay and comprehensive benefits including health insurance, 401K, and flexible work arrangements.

Qualifications

• 4+ years of related experience required.
• Knowledge of utilization management principles preferred.
• CA RN LICENSE REQUIRED.

Responsibilities

• Supervises Prior Authorization, Concurrent Review, and/or Retrospective Review Clinical Review team.
• Monitors and tracks UM resources for performance and compliance.
• Collaborates with the utilization management team to resolve complex care issues.

Skills

Utilization management principles

Team leadership

Compliance monitoring

Clinical assessment

Education

Graduate of an Accredited School Nursing or Bachelor's degree

Job description

Centene Corp. is seeking a Supervisor, Utilization Management (RN) to lead and supervise our Clinical Review team. This role focuses on ensuring appropriate care for our members and promotes adherence to compliance standards through effective team management and continuous improvement practices.

Candidates should possess a nursing degree and a valid California RN license, along with 4+ years of experience in utilization management or related fields. The position offers competitive pay and comprehensive benefits including health insurance, 401K, and flexible work arrangements.